Effect of forceps biopsy on bronchial washing results in patients with endoscopically visible lung tumors

Ahmed,Harem K.; Qaradakhy,Kamaran Amin; Ali,Kosar Mohamed; Kakamad,Fahmi H.; Abdalla,Berun A.; Hiwa,Dilan S.

doi:10.3892/wasj.2024.272

Effect of forceps biopsy on bronchial washing results in patients with endoscopically visible lung tumors

Authors:
- Harem K. Ahmed
- Kamaran Amin Qaradakhy
- Kosar Mohamed Ali
- Fahmi H. Kakamad
- Berun A. Abdalla
- Dilan S. Hiwa
View Affiliations

Affiliations: Department of Scientific Affairs, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq, College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
Published online on: August 7, 2024 https://doi.org/10.3892/wasj.2024.272
Article Number: 57
Copyright : © Ahmed et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Enhancing diagnostic bronchoscopy techniques is paramount for lung cancer detection; bronchial washing is one of those modalities. However, there is controversy regarding the optimum sequence of performing this procedure in relation to biopsy. The present study aimed to assess the most effective sequence of bronchial washing in relation to bronchial biopsy for diagnosing lung cancer. The present study was a single‑center prospective study carried out over a period of 18 months. The study included patients >18 years of age with mass or suspected lesions on a chest computed tomography and an endoscopically visible mass. They were randomly assigned to a bronchial washing before the forceps biopsy group and a bronchial washing after the forceps biopsy group. Bronchial washing and forceps biopsy were performed under cytological and histopathological analysis, respectively. The present study included 50 patients with a mean age of 72 years. The males comprised 36 (72%) of the patients. The pre‑biopsy bronchial wash (pre‑BW) yielded positive results in 21 (42%) patients, and the post‑biopsy bronchial wash (post‑BW) yielded positive results in 23 (46%) patients. The biopsy results revealed that 22 (44%) of the cases were squamous cell carcinoma, 18 (36%) were adenocarcinoma, 8 (16%) were small cell lung carcinoma, 1 (2%) was acinar cell carcinoma, and 1 (2%) was not malignant. A comparison of pre‑BW and post‑BW revealed a statistically significant difference between them (P‑value <0.001). Pre- and post-BW may affect the yield of diagnostic outcomes for endoscopically visible lung tumors. However, additional research, such as studies using larger sample sizes or meta-analyses, is required to determine the efficacy of this approach.

View Figures

View References

1	Mingomataj E, Krasniqi M, Dedushi K, Sergeevich KA, Kust D, Qadir AA, Abdullah AS, Ahmed MK and Fatah GM: Cancer Publications in One Year (2023): A Cross-Sectional Study. Barw Med J. 2:3–11. 2024.
2	Bade BC and Cruz CS: Lung cancer 2020: Epidemiology, etiology, and prevention. Clin Chest Med. 41:1–24. 2020.PubMed/NCBI View Article : Google Scholar
3	Nooreldeen R and Bach H: Current and future development in lung cancer diagnosis. Int J Mol Sci. 22(8661)2021.PubMed/NCBI View Article : Google Scholar
4	Rao S, Rao S, Lal A, Barathi G, Dhanasekar T and Duvuru P: Bronchial wash cytology: A study on morphology and morphometry. J Cytol. 31:63–67. 2014.PubMed/NCBI View Article : Google Scholar
5	Roncarati R, Lupini L, Miotto E, Saccenti E, Mascetti S, Morandi L, Bassi C, Rasio D, Callegari E, Conti V, et al: Molecular testing on bronchial washings for the diagnosis and predictive assessment of lung cancer. Mol Oncol. 14:2163–2175. 2020.PubMed/NCBI View Article : Google Scholar
6	Schramm D, Freitag N, Nicolai T, Wiemers A, Hinrichs B, Amrhein P, DiDio D, Eich C, Landsleitner B, Eber E, et al: Pediatric airway endoscopy: Recommendations of the society for pediatric pneumology. Respiration. 100:1128–1145. 2021.PubMed/NCBI View Article : Google Scholar
7	Patil S, Toshniwal S and Acharya A: Role of fiberoptic bronchoscopy-guided needle aspiration cytology (EBNA) in diagnosing lung cancer in endobronchial lesions: A single-center experience. Int J Mol Immuno Oncol. 8:15–22. 2023.
8	Xia Y, Li Q, Zhong C, Wang K and Li S: Inheritance and innovation of the diagnosis of peripheral pulmonary lesions. Ther Adv Chronic Dis. 14(20406223221146723)2023.PubMed/NCBI View Article : Google Scholar
9	Wang J, Zhang T, Xu Y, Yang M, Huang Z, Lin J, Xie S and Sun H: Comparison between percutaneous transthoracic co-axial needle CT-guided biopsy and transbronchial lung biopsy for the diagnosis of persistent pulmonary consolidation. Insights Imaging. 14(80)2023.PubMed/NCBI View Article : Google Scholar
10	Lim JH, Kim MJ, Jeon SH, Park MH, Kim WY, Lee M, Kim JH, Kim JS, Kim YS, Kim L, et al: The optimal sequence of bronchial brushing and washing for diagnosing peripheral lung cancer using non-guided flexible bronchoscopy. Sci Rep. 10(1036)2020.PubMed/NCBI View Article : Google Scholar
11	Abdullah HO, Abdalla BA, Kakamad FH, Ahmed JO, Baba HO, Hassan MN, Bapir R, Rahim HM, Omar DA, Kakamad SH, et al: Predatory publishing lists: A review on the ongoing battle against fraudulent actions. Barw Med J. 2:26–30. 2024.
12	Karahalli E, Yilmaz A, Türker H and Özvaran K: Usefulness of various diagnostic techniques during fiberoptic bronchoscopy for endoscopically visible lung cancer: Should cytologic examinations be performed routinely? Respiration. 68:611–614. 2001.PubMed/NCBI View Article : Google Scholar
13	Kvale PA, Bode FR and Kini S: Diagnostic accuracy in lung cancer; comparison of techniques used in association with flexible fiberoptic bronchoscopy. Chest. 69:752–757. 1976.PubMed/NCBI View Article : Google Scholar
14	Jones AM, Hanson IM, Armstrong GR and O'Driscoll BR: Value and accuracy of cytology in addition to histology in the diagnosis of lung cancer at flexible bronchoscopy. Respir Med. 95:374–378. 2001.PubMed/NCBI View Article : Google Scholar
15	Govert JA, Dodd LG, Kussin PS and Samuelson WM: A prospective comparison of fiberoptic transbronchial needle aspiration and bronchial biopsy for bronchoscopically visible lung carcinoma. Cancer. 87:129–134. 1999.PubMed/NCBI View Article : Google Scholar
16	Lee HS, Kwon SY, Kim DK, Yoon HI, Lee SM, Lee JH, Lee CT, Chung HS, Han SK, Shim YS and Yim JJ: Bronchial washing yield before and after forceps biopsy in patients with endoscopically visible lung cancers. Respirology. 12:277–282. 2007.PubMed/NCBI View Article : Google Scholar
17	Carvalho AS, Cuco CM, Lavareda C, Miguel F, Ventura M, Almeida S, Pinto P, de Abreu TT, Rodrigues LV, Seixas S, et al: Bronchoalveolar lavage proteomics in patients with suspected lung cancer. Sci Rep. 7(42190)2017.PubMed/NCBI View Article : Google Scholar
18	Endalie D and Abebe WT: Analysis of lung cancer risk factors from medical records in Ethiopia using machine learning. PLoS Digital Health. 2(e0000308)2023.PubMed/NCBI View Article : Google Scholar
19	Stanzel F: Bronchoalveolar Lavage. In: Principles and Practice of Interventional Pulmonology. Ernst A and Herth FJF (eds). Springer Nature, pp165-176, 2012.
20	Lee HW, Park YS, Park S and Lee CH: Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations. Sci Rep. 10(14933)2020.PubMed/NCBI View Article : Google Scholar
21	Xie X, Li X, Tang W, Xie P and Tan X: Primary tumor location in lung cancer: The evaluation and administration. Chin Med J (Engl). 135:127–136. 2021.PubMed/NCBI View Article : Google Scholar
22	Drilon A, Rekhtman N, Ladanyi M and Paik P: Squamous-cell carcinomas of the lung: emerging biology, controversies, and the promise of targeted therapy. Lancet Oncol. 13:e418–e426. 2012.PubMed/NCBI View Article : Google Scholar
23	Biciuşcă V, Popescu IAS, Traşcă DM, Olteanu M, Stan IS, Durand P, Camen GC, Bălteanu MA, Cazacu IM, Demetrian AD, et al: Diagnosis of lung cancer by flexible fiberoptic bronchoscopy: A descriptive study. Rom J Morphol Embryol. 63:369–381. 2022.PubMed/NCBI View Article : Google Scholar
24	Hou G, Miao Y, Hu XJ, Wang W, Wang QY, Wu GP, Wang EH and Kang J: The optimal sequence for bronchial brushing and forceps biopsy in lung cancer diagnosis: A random control study. J Thorac Dis. 8:520–526. 2016.PubMed/NCBI View Article : Google Scholar
25	Chaudhary BA, Yoneda K and Burki NK: Fiberoptic bronchoscopy: Comparison of procedures used in the diagnosis of lung cancer. J Thorac Cardiovasc Surg. 76:33–37. 1978.PubMed/NCBI
26	Fernández-Villar A, González A, Leiro V, Represas C, Botana MI, Blanco P, Mosteiro M and Piñeiro L: Effect of different bronchial washing sequences on diagnostic yield in endoscopically visible lung cancer. Arch Bronconeumol. 42:278–282. 2006.PubMed/NCBI View Article : Google Scholar : (In Spanish).
27	Raymond NJ, McLeod S and Thornley PE: Timing of bronchial washing at fibrebronchoscopy improves the diagnostic rate of primary bronchial carcinoma. Thorax. 46 (Suppl)(S289)1991.
28	Yigla M, Nagiv D, Solomonov A, Malberger E, Ben-Izhak O, Rubin AH and Keren R: Timing of collecting bronchoscopic cytologic specimens in endobronchial malignant neoplasms. Journal of Bronchology & Interventional Pulmonology. 9:272–275. 2002.
29	van der Drift MA, van der Wilt GJ, Thunnissen FB and Janssen JP: A prospective study of the timing and cost-effectiveness of bronchial washing during bronchoscopy for pulmonary malignant tumors. Chest. 128:394–400. 2005.PubMed/NCBI View Article : Google Scholar